FORT LAUDERDALE, Fla. — Despite an outbreak of measles last year in a Weston elementary school, Broward County saw a dramatic drop in its immunization rate for kindergartners in 2025.

In Broward, only 82.2% of 2024-25 kindergartners got their required vaccinations — the lowest level in 15 years. The public health goal is a vaccination rate of 95% — the level that makes it unlikely that a single infection will spark a disease cluster or outbreak.

The declining rate reflects the heated debate raging on social media and among South Florida parents.

“There’s a lot of distrust in the health system,” said Daniela Rodriguez, a Broward County mother with two children in elementary school and a 1-year-old. “After COVID, people have gotten more educated about vaccines and have started questioning things that weren’t questioned before.”

Public health officials focus on vaccination rates for kindergartners because elementary schools can be hot spots for germs and origins of community spread. By kindergarten, children must be vaccinated for diseases including measles, mumps, rubella, polio, chicken pox, and Hepatitis B. Outbreaks often start in small, localized areas, where the level of vaccination in that community determines its risk.

The other South Florida counties also have low immunization coverage in kindergartners. Palm Beach County reported 89.8% of 2024-25 kindergartners received their required vaccines, and Miami-Dade reported 91%.

Florida’s statewide rate for kindergarten vaccinations is 88.8%, well below the national average of 93%.

“When the rate is low, we are at an increased risk of some of these diseases we have seen eliminated making a comeback,” said Jennifer Takagishi, a Tampa pediatrician and vice president of the Florida Chapter of the American Academy of Pediatrics.

One of the vaccines given before kindergarten is for pertussis (whooping cough), which young children are more prone to catching during the fall and winter months. Florida has already had a record number of whooping cough cases in 2025 — more than 1,100 cases compared with 391 in 2019, before the pandemic. Children diagnosed with whooping cough, a respiratory infection, can lose their breath, have apnea spells, or vomit. Health experts expect to see a continued rise.

“Vaccination declines we saw during the COVID-19 pandemic aren’t rebounding,” said Takagishi, adding that it may take a year or two before the lowered immunization rate is reflected in a rash of diseases.

Exemptions are setting records

Florida law requires that students entering kindergarten be vaccinated for certain contagious diseases; however, they can be exempted by their doctor for medical reasons or by their parents if they affirm the shots conflict with the family’s religious practices. Across the U.S., the share of children with exemptions from required vaccines rose to an all-time high of 3.6% in 2024-25. In Florida, the group of kids exempted from vaccine requirements was 6.29%, surpassing the national average. And in some Florida counties, the exemption rate is as high as 15.03%, according to state health data.

The Florida Department of Health notes on its website: “The proportion of children age 5-17 years with new religious exemptions is increasing each month.” This implies that more parents choose to avoid at least some vaccines for their children.

With more children in schools who are unvaccinated, parents and older relatives are at risk, too.

“It’s not just about the danger of disease for the children; it is also dangerous for parents who may or may not have had a vaccine, for people whose immune systems are not working well, and for people who are older and were vaccinated a long time ago,” Takagishi said. “It’s putting a lot of people at risk.”

In February 2024, an outbreak of measles spread through Manatee Bay Elementary School in Weston, where 33 of the school’s 1,067 students lacked at least one shot of the two-dose measles vaccine. By the end of the outbreak, the disease had spread to nine children between birth and 14 years old. No adults were affected. However, so far this year, within the U.S., 462 people over age 20 have gotten measles compared with 77 in 2024, according to the Centers for Disease Control & Prevention.

Each person’s risk for diseases such as measles varies, said Dr. Lewis Nelson, dean of Florida Atlantic University’s Schmidt College of Medicine.

“We don’t really have a lot of great information on how good your immune response will be to an exposure if you got a vaccine many years ago,” Lewis said. “But what we do understand is that for most vaccines, most infections that have left you immunized, you store memory cells in your body that will react when you’re reexposed.”

What is behind South Florida’s low vaccination coverage?

Health experts say the COVID pandemic shifted vaccine hesitancy into high gear. Conversations with local parents bear that out.

“COVID opened eyes when we saw that vaccines didn’t work and in some cases they did harm,” said Rodriguez, the Broward County mother of three.

Rodriguez said an outbreak of measles in the elementary school would cause her worry, regardless of whether her children were vaccinated. Still, she wants to see more research on childhood vaccines, their effectiveness, and their adverse effects as she considers choices for her youngest child. “We need answers, and better studies.”

Local pediatricians see parents’ hesitancy in their exam rooms.

Dr. Michael Glazier, a pediatrician and chief medical officer of Bluebird Kids Health in Tamarac, said parents have more questions about vaccines. “They want more discussion, and there should be discussion. Medicine should be about shared decision-making,” he said. “Part of my role is to provide medical expertise and be a sounding board. My plea to parents is to ask questions but also keep an open mind. I don’t want children to suffer from something preventable.”

Some pediatric offices have announced that they will no longer provide care to families who have opted out of vaccination without a medical exemption.

Glazier said Bluebird Kids requires patients to be vaccinated eventually, but will work with parents on their child’s vaccine schedule.

As a parent and pediatrician, Glazier said he is disheartened by Florida’s downward trend in childhood immunization rates. “There are some children who can’t get a vaccine because they’ve had an anaphylaxis reaction or they are immunocompromised,” he said. “When the rate trends down, they are at a higher risk and more susceptible to diseases that can cause morbidity or death.”

Because of post-pandemic skepticism, pediatric organizations find themselves working harder to convey the safety of vaccines, even as the Department of Health and Human Services announced this week that, at the request of anti-vaccination advocates, it is reinstating the Task Force on Safer Childhood Vaccines, which disbanded in 1998.

Dr. Kathleen Mueller, an American Academy of Family Physicians board member, told Parents Magazine that vaccines are rigorously tested, undergo widespread research, and are subject to trials and safety checks led by the U.S. Food and Drug Administration before being offered to the public.

“The politically-based reaction to the COVID vaccine seems to have spilled over to other vaccines, and there has been a dramatic spike in online content across all social media platforms, pushing a false narrative around various anti-vaccine talking points such as ‘vaccines don’t undergo safety trials,'” Mueller said.

All vaccines carry risk

Nelson at FAU said while there is some risk of harm from childhood vaccines, it’s minuscule compared to the danger of a contagious disease.

“Some of these diseases are quite devastating,” he said. “Measles and mumps might be relatively benign diseases and most people don’t have long-term consequences, although there are unquestionably liver injuries and other things like brain swelling. But polio is a terrible lifelong disease that, if you don’t die from it, you could be left with severe incapacitation.”

Nelson acknowledges that vaccination is an individual choice, but wants parents to understand the broader implications. Each unvaccinated child becomes a vector to spread the disease, even if the child does not become sick.

“So, within schools, each percentage point (in immunization rate) you go down from 95 to 90 to 85, it increases the number of exposure opportunities you have to give the disease to somebody who is susceptible to it,” he said. “By increasing the amount of vaccinations across the population, it just provides fewer hosts to transmit the virus to the next person.”

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